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What do I do if the target blood pressure has not been reached by the primary antihypertensive therapy?
● If your initial treatment was a monotherapy and had no effect at all despite escalation to the maximal approved dose, switch to an antihypertensive drug with a different pharmacological mechanism.
● If lowered blood pressure was detected but was insufficient, include a second drug with a different pharmacological mechanism.
● In a high-risk patient your initial treatment most likely was a two-drug combination. If no effect at all, switch to a different two-drug combination. If the lowering of the blood pressure was insufficient, include a third appropriate drug.
● Above-the-target blood pressure in spite of concurrent use of three antihypertensive agents belonging to different antihypertensive drug classes is defined as resistant hypertension. It can be treated by including a 2nd line antihypertensive drug such as urapidil or - if available - interventionally by renal sympathetic denervation.
≣ Fig. 3
● If lowered blood pressure was detected but was insufficient, include a second drug with a different pharmacological mechanism.
● In a high-risk patient your initial treatment most likely was a two-drug combination. If no effect at all, switch to a different two-drug combination. If the lowering of the blood pressure was insufficient, include a third appropriate drug.
● Above-the-target blood pressure in spite of concurrent use of three antihypertensive agents belonging to different antihypertensive drug classes is defined as resistant hypertension. It can be treated by including a 2nd line antihypertensive drug such as urapidil or - if available - interventionally by renal sympathetic denervation.
≣ Fig. 3
Karteninfo:
Autor: LWojnowski
Oberthema: Medicine
Thema: Pharmacology
Schule / Uni: University Clinical Center
Ort: Mainz
Veröffentlicht: 24.05.2013